By Gina Macris

A federal court monitor says the state of Rhode Island has had “mixed results” in its efforts to find competitive employment for adults with developmental disabilities as required by a 2014 civil rights decree mandating the state correct violations of the Americans With Disabilities Act.

The monitor, Charles Moseley, has urged the state to take “immediate and tangible steps” to develop the capacity of both state agencies and private service providers “to sustain the high level of training and supported employment activity required by the Consent Decree both now and into the future. “

The state licenses about three dozen private agencies, most of them non-profits, to provide the direct services for adults with developmental disabilities that the state relies on to meet the goals of the consent decree, both for supported employment and non-work activities in the community.

The state has met employment goals for January 1, 2019 in two of three categories of adults with developmental disabilities, those who previously worked in sheltered workshops and those who historically were served in segregated day centers. But the pace of placements has slowed at a time when the requirements of the consent decree are set to accelerate, from 2020 to 2024, according to figures presented by Moseley.

In the first three months of 2019, a total of 18 adults with developmental disabilities landed jobs. That is the second-lowest quarterly total on record for the first five years of the consent decree. The lowest quarterly job placement rate occurred from July through September, 2018, when only 7 individuals got jobs.

Moseley’s report zeroed in on a third category in the consent decree, young adults recently out of high school. The state has never met target numbers for job placements for that group. As of March 31, the number of young adults with part-time jobs stood at 257, or about 62 percent of a population of 412 persons in their twenties.

Moseley said that the state’s performance-based supported employment program, launched in 2017, “did not significantly impact placement numbers” for young adults.

The state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) recently issued a request for proposals for a new iteration of the individualized supported employment program that appears to be tailored to young adults, in that that it seeks clients who have never held jobs.

“We continue to see PCSEPP (The Person-Centered Supported Employment Performance Program) as one of the strategies to increasing employment outcomes,” a BHDDH spokesman said in a statement July 29. “It has provided the state with two years of data-informed outcomes and continues to be responsive to providers’ requests for innovative and flexible resources to promote employment outcomes,” the statement said.

BHDDH set an Aug. 30 deadline for the submission of proposals from private providers, but those agencies have asked for an extension.

At a meeting July 12, representatives of private providers asked for at least three months to plan their programs, because of a requirement that the services reflect a formal collaboration between two or more agencies. The agencies need time to consider structural changes to their operations that may be required by the collaboration, their representatives said.

BHDDH has extended the application deadline to Oct. 4, according to a memo to providers dated July 19.

In his report, Moseley noted that the “state is taking important steps to rebuild the developmental disabilities service delivery system under the Consent Decree.”

He cited efforts by the Division of Developmental Disabilities and the Office of Rehabilitation Services to “establish important links” with providers, families, advocacy organizations and the state Department of Labor and Training to “achieve and sustain supported employment outcomes” among those facing intellectual or developmental challenges. BHDDH is also working with the special legislative commission studying the state’s fee-for-service reimbursement rate, Moseley said. He noted that there has been additional progress in the training of providers’ staff, quality improvement measures and other key areas.

But in a recent conference call with the Employment First Task Force, a community advisory group on implementation of the consent decree, he echoed the conclusion of his most recent quarterly report.

When members of the group thanked Moseley for his work -– he is stepping down as monitor Sept. 30 — and asked him for advice on their recently-completed strategic plan, Moseley said they should focus on one in the plan that concerns providers’ capacity to do their jobs.

Moseley said he has heard “a lot” about adults with developmental disabilities being unable to access any suitable services from a provider and instead choosing to “self-direct.” That means consumers and families design their own programs and hire and supervise staff. The phenomenon has sometimes been called “self-directed by default.”

This is one area that would benefit from a workgroup including providers and state officials to try to “capture” the problem, which can be difficult to document when one family applies to multiple agencies, he said.

Read Moseley’s report here.

(This article has been updated.)